[Resistance and new antibiotic strategies. The other new molecules].

ANTI-PNEUMOCOCCAL DRUGS: New fluoroquinolones with different targets than earlier compounds have been found to be active in certain cases of respiratory tract pneumococcal infections. Moxifloxacin, levofloxacin and gatifloxacin have been particularly effective. These new antibiotics can be classed in a new category of "respiratory quinolones". EFFLUX PUMP INHIBITORS: The bacterial efflux systems are complex resistance mechanisms allowing the bacteria to expulse certain antibiotics belonging to several drug families and thus to develop multiple resistance capacities. A new series of efflux pump inhibitors has been recently synthesized. Associated with an antibiotic (levofloxacin, macrolide) these inhibitors significantly increase antibacterial activity. BACTERIAL WALL INHIBITORS: These compounds target the biosynthesis units of the bacterial walls, inhibiting for example bacterial enzyme Mur A. CYCLIC LIPOPEPTIDES: These include daptomycin which acts on peptidoglycan synthesis in the bacterial wall via a mechanism different from that of glycopeptides. NEW BETA-LACTAMS: Faropenem is a new member of the penem family. Ceftidoren is an oral cephalosporin that gives 64 to 70% cure after 7 to 10 days in cases of acute maxillary sinusitis and 81 to 83% in exacerbations of acute bronchial infections. In streptococcal pharyngitis in adults, ceftidoren produces better eradication (90%) of S. pyogenes than penicillin V (83%) at treatment end.